The Illustrative Magnetic Resonance Imaging of the Chondral and the Osteochondral Lesions

2020 ◽  
pp. 57-76
Author(s):  
Drushi Patel ◽  
Ankur Shah ◽  
Deepak Rajkumar Goyal
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondral Lesions ◽  
Resonance Imaging

scholarly journals Reconstruction of osteochondral defects by combined bone grafting and a bilayer collagen membrane as a sandwich technique

2013 ◽  
Vol 5 (4) ◽  
pp. 36 ◽  
Author(s):  
Maximilian Petri ◽  
Max Ettinger ◽  
Christian Von Falck ◽  
Nael Hawi ◽  
Michael Jagodzinski ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Grafting ◽  
International Knee Documentation Committee ◽  
Osteochondral Lesions ◽  
Collagen Membrane ◽  
Osteochondral Defects ◽  
Resonance Imaging ◽  
Sandwich Technique ◽  
Chondrocyte Implantation

Treatment of osteochondral lesions of the knee remains a major challenge in orthopedic surgery. Recently established procedures like autologous chondrocyte implantation or matrix-associated chondrocyte implantation yield good results, but include the disadvantage of two-step procedures. The purpose of this study was to evaluate the clinical and magnetic resonance imaging outcome of repairs of osteochondral defects of the knee by a combined procedure of bone grafting and covering with a bilayer collagen membrane in a sandwich technique. Seven male patients with a mean age of 42 (range 30-55) years and symptomatic focal osteochondral lesions of the knee grade IV according to the International Cartilage Repair Society classification were included. The mean diameter of defects was 28.6 (range 15-40) mm. Results were evaluated at a minimum of 24 months after surgery by International Knee Documentation Committee score, Lysholmscore, visual analogue scale, and magnetic resonance imaging with specific cartilage sequences, evaluating the ICRS score and the Magnetic Observation of Cartilage Repair Tissue (MOCART) score. All patients judged the operation as successful. Among the patients available for the long-term follow-up, mean visual analogue scale value was 1.3 (range 0-3) out of 10 points. Mean International Knee Documentation Committee score was 80.8 (range 63.2-88.5) out of 100 points. Mean Lysholm score was 85 (range 55-95) out of 100 points. None of the patients had to be reoperated until today. Evaluation of magnetic resonance imaging using the MOCART score revealed a good correlation to the clinical outcome. This is the first study reporting results after reconstruction of osteochondral defects of the knee joint by bone grafting and a bilayer collagen membrane. This new method offers the advantage of a one-step-procedure and yields both good clinical and magnetic resonance findings. We conclude that this procedure can be a valuable tool to improve joint function after osteochondral defects, trauma, and in joints with local arthritic lesions.

Magnetic Resonance Imaging and Outcomes of Osteochondral Lesions of the Talus Associated With Ankle Fractures

2020 ◽  
Vol 41 (10) ◽  
pp. 1219-1225
Author(s):  
Seçkin Özcan ◽  
Nizamettin Koçkara ◽  
Yalkın Camurcu ◽  
Hakan Yurten
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Results ◽  
Ankle Fractures ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Aofas Score ◽  
Prospective Comparative Study ◽  
The Mean ◽  
Second Year

Background: Osteochondral lesions of the talus (OCLTs) secondary to ankle fractures have previously been reported in the literature. However, no study has evaluated OCLTs using magnetic resonance imaging (MRI) following ankle fracture treatment. The purpose of our study was to investigate accompanying OCLTs in patients with an ankle fracture and evaluate its relationship with the clinical outcomes. Methods: Fifty-six patients with ankle fractures who were treated with either a nonoperative or operative method at our center between June 2016 and February 2017 were included in this prospective comparative study (37 men and 19 women; mean age, 44.6 ± 13 years; range, 20-65 years). The mean American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate the clinical results in all patients in the second month and second year. The second-month ankle MR images were evaluated for OCLTs in all patients. Thirty patients were treated operatively and 26 nonoperatively. Results: Accompanying OCLTs were detected in 19 of 56 patients (34%). Our results showed no statistically significant association between OCLT and fracture type, as well as the treatment type. In the second postoperative month, the mean AOFAS scores were 87.2 ± 10.8 and 77.6 ± 12.0 in patients with and without OCLTs, respectively ( P = .005). In the second postoperative year, the mean AOFAS scores were 81.3 ± 6.8 and 86.2 ± 8.4 in patients with and without OCLTs, respectively ( P = .031). The mean AOFAS score significantly decreased in the OCLT group in the second-year control, whereas a significant increase was observed in patients without OCLTs ( P = .026 and P < .001, respectively). Conclusion: According to our results, the accompanying OCLTs were found in one-third of patients treated for ankle fractures. We observed a significant correlation between OCLT presence and the AOFAS score. According to the AOFAS score, OCLTs statistically significantly affected clinical results at 2 years. Level of Evidence: Level II, prospective comparative study.

Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/Blood Implant vs Microfracture for Osteochondral Lesions of the Talus

2020 ◽  
Vol 41 (11) ◽  
pp. 1368-1375
Author(s):  
Yalkin Camurcu ◽  
Hanifi Ucpunar ◽  
Furkan Yapici ◽  
Resit Karakose ◽  
Seckin Ozcan ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Glycerol Phosphate ◽  
Level Of Evidence ◽  
Repair Tissue ◽  
Significant Difference ◽  
The Mean ◽  
Group 1

Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 ( P = .022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups ( P = .257 and .242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.

Pediatric Osteochondral Lesions

2018 ◽  
Vol 22 (01) ◽  
pp. 057-065 ◽  
Author(s):  
Selwan Abdullah ◽  
Ramesh Iyer ◽  
Narendra Shet
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Management Strategies ◽  
Osteochondral Lesions ◽  
Imaging Features ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Imaging Appearance ◽  
Magnetic Resonance Imaging Assessment ◽  
The Stability

AbstractOsteochondral lesions are common in children and may arise from a variety of etiologies. Although they most frequently occur in the knee, other joints may be involved including the ankle and elbow. We describe the typical imaging appearance of osteochondral lesions with a focus on radiographs and magnetic resonance imaging. Assessment of the stability of these lesions is of paramount importance in directing management. As such, we describe staging schemes as well as imaging features differentiating stable from unstable lesions. Finally, we briefly discuss management strategies as they correlate to imaging findings.

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